Tapentadol vs Tramadol: Comparing Pain Relief Medications

Tapentadol vs. Tramadol is an extensively discussed comparison in people suffering from chronic body pain. This type of pain persists for a long period, typically for a few months to a few years. 

A survey report by the CDC states that about 20.8% of American adults struggle with body pain [1]. Most chronic pain does not respond well to the conventional analgesic and requires more potent treatment options. 

Two common FDA-approved analgesics to be prescribed for severe chronic pain are Tapentadol and Tramadol. This comparative analysis is to help readers make a better decision between Tapentadol and Tramadol.

Tramadol And Tapentadol- A Brief Outline

Tramadol is a centrally-acting analgesic used for moderate to severe pain that was developed and patented in 1962. Its medical use was first approved in Germany in 1977 by the pharmaceutical company Grünenthal GmbH. The FDA approved Tramadol for medical use on March 3, 1995, under the brand Ultram.

Tapentadol is a novel opioid analgesic developed in 1980. The FDA approved its clinical use in 2008 in the US and Europe in 2010. It is an advanced pain management option where a single molecule can deliver analgesia through two working mechanisms. Available under the brand names Nucynta and Aspadol, it is effective across a broad spectrum of pain. Tapentadol is also known as the “orange painkiller” due to the color of the tablet. 

Similarities Between Tramadol And Tapentadol 

Tapentadol and Tramadol showcase resemblances on specific comparative grounds, making it hard for most users to decide. Two distinct similarities between them are listed below. 

Drug Class:

They are both classified as opioid pain medications. These are strong pain relievers that work by binding to opioid receptors in the body.

Clinical uses: 

They are approved for treating moderate to severe acute and chronic pain that do not respond well to non-opioid analgesics. 

Tapentadol is approved for diabetic neuropathy in the USA. Whereas a few randomized controlled trials suggest that the evidence supporting using Tramadol for neuropathy is very low. 

A study by Srinivas Kalyanaraman Iye et al. demonstrates that Tapentadol is more potent for postoperative discomfort than Tramadol. Tramadol patients needed a higher level of "rescue analgesic" for better pain relief than Tapentadol, as shown below. 

Rescue analgesics are prescribed when the primary pain medication fails to deliver effective results. This indicates that the use of Tapentadol for post-operative body pain is a much more effective choice than Tramadol. 

Difference Between Tramadol And Tapentadol

Apart from the similarities, a few notable differences between them are listed below. 

Effectiveness And Potency

Tapentadol is two to three times more effective and potent than Tramadol, states Lucien Roulet et al. in a 2021 study. 

Generic Tablets Availability

No low-cost generic tablet is available for Tapentadol. However, Tramadol is available in generic form. 

Legal Status

Tapentadol is a controlled substance and is classified as a Schedule II prescription drug by the Drug Enforcement Administration (DEA). Tramadol, on the other hand, is a Schedule IV drug in the USA. 

These medications are available through medical prescription and cannot be bought over the counter. 

Availability

Tramadol is available in 40 countries, including Canada, Australia, USA, China, Russia, Japan, and India. Meanwhile, Tapentadol is available in 28 countries. 

Cost and Affordability

The cost of Tapentadol and Tramadol may vary depending on factors such as pharmacy, available offers and discounts, and pill packages. 

Generic Tapentadol tablets are unavailable; thus, Healthnaturo retails Aspasol 100 mg tablets at $2.77 per pill. 

The cost of Tramadol (Ultram) 50mg in some of the local pharmacies in the US is listed below. 

• Costco- $3.9 per pill.

• CVS- $3.7 per pill.

• Target- $3.7 per pill.

• Walgreens- $3.7 per pill.

Mechanism Of Action 

Both pain medications work by blocking the pain signals from reaching the brain receptors. 

Further, it also helps boost the body's natural pain control system, thus reducing the overall feeling of pain.

Tapentadol Vs Tramadol- Dosing Guidelines 

The recommended dose of Tapentadol and Tramadol is 100mg every 4 to 6 hours. Meanwhile, the extended-release (ER) formula should be taken every 12 hours. The Tapentadol ER medications are formulated to release the active compound over a specific period. 

• Dosage form- Tapentadol is available as an oral tablet, whereas Tramadol is available as an injection and an oral tablet. 

• Strengths- Tramadol is available in four dosages: 50mg, 100mg, 150mg, and 200mg. However, only 50 mg and 100mg of Tapentadol tablets are available. 

• Maximum Dosage- The maximum daily dose of Tapentadol is 700 mg and 400 mg for Tramadol. 

Abuse Potential

Tramadol has a lower potential for abuse compared to Tapentadol.

Some of the common signs of abuse of Tapentadol and Tramadol in users are-

• Pupil becoming small 

• Chest pain

• Nausea 

• Clammy skin

Side Effects  

The frequency of occurrence of adverse effects reported from Tapentadol and Tramadol may vary depending on the doses and strength. The common side effects of Tapentadol and Tramadol are listed below. 

• Vomiting and Nausea

• Constipation

• Psychosis

Tapentadol Vs Tramadol - Drug Interactions

Using these medications with other treatments can induce drug interaction. It can cause unpredicted side effects with diminished or heightened drug action possibilities. 

Tramadol drug interaction is known to interact with 644 medications, whereas Tapentadol may interact with 372 drugs. 

• Tramadol Drug Interaction: 302 major drug interactions, 340 moderate drug interactions, and 2 minor drug interactions.

• Tapentadol Interaction: 183 major interactions, 188 moderate interactions, and 1 minor interaction. 

Can You Take Tapentadol With Tramadol?

Taking Tapentadol and Tramadol together is known to cause major drug interaction resulting in central nervous system depression, causing coma, profound sedation, respiratory distress, and death in rare and extremely severe cases. 

If coadministration is necessary, such patients should be monitored for signs of sedation and respiratory depression. They are advised not to use hazardous machinery and to avoid driving. 

Is Tapentadol Stronger Than Tramadol- Our Final Thoughts 

Tapentadol is considered to be a compound with a better clinical and safety profile. It overcomes some of the limitations of Tramadol, such as drug interaction, lower effectiveness, and longer onset of action. 

Tapentadol's efficacy in treating a wide range of acute and chronic pain and its better tolerability profile than traditional opioids give it the upper hand over Tramadol. 

Let us further sum up all the benefits and demerits of both Tapentadol and Tramadol to understand the right analgesic choice.